{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:31:12Z","timestamp":1773145872290,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1995,8]]},"abstract":"<jats:p>Spontaneous dissection of the coronary arteries is an uncommon condition that may lead to sudden, fatal coronary artery occlusion. Three cases of sudden death attributable to coronary artery occlusion are presented. Dissection was associated with Marfan's syndrome in the first case, and occurred three weeks postpartum in the second case. In case 1, dissection occurred within the intima, and was not associated with an inflammatory cell infiltrate. In cases 2 and 3, dissection occurred between the tunica media and the external elastic lamina, and was associated with a mixed inflammatory infiltrate, rich in eosinophils, T lymphocytes, and histiocytes. The spatial limitation of the inflammatory infiltrate to the adventitial compartment, together with the absence of inflammation in case 1, suggests a reactive origin rather than a causative role for the inflammatory cells. Detailed examination of serial blocks of any coronary artery occlusion is essential in young patients.<\/jats:p>","DOI":"10.1136\/jcp.48.8.781","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"781-784","source":"Crossref","is-referenced-by-count":51,"title":["Sudden death from coronary artery dissection."],"prefix":"10.1136","volume":"48","author":[{"given":"A C","family":"Bateman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Gallagher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A C","family":"Vincenti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,8,1]]},"reference":[{"key":"ref_1","article-title":"Discussion Dissection of the coronary arteries is an uncommon condition. It was first described in 1931, and occurs most frequently in young women.' Corrado et al2 found coronary artery dissection in three of 150 cases of sudden death in subjects aged 35 years or less. The left anterior descending coronary artery is most commonly involved.3 The factors predisposing to coronary artery dissection are summarised in the table. Two of the three cases in the present report possessed such associations. Case 1 was a diagnosed example of Marfan's syndrome, and case 2 was a young woman in the postpartum period. The hormonal and other physiological changes associated with pregnancy, and the physical strain of labour have been proposed as contributory factors in this association, but the exact mechanism remains unclear. Case 3 differed in that no predisposing factor could be identified","unstructured":"Discussion Dissection of the coronary arteries is an uncommon condition. It was first described in 1931, and occurs most frequently in young women.' Corrado et al2 found coronary artery dissection in three of 150 cases of sudden death in subjects aged 35 years or less. The left anterior descending coronary artery is most commonly involved.3 The factors predisposing to coronary artery dissection are summarised in the table. Two of the three cases in the present report possessed such associations. Case 1 was a diagnosed example of Marfan's syndrome, and case 2 was a young woman in the postpartum period. The hormonal and other physiological changes associated with pregnancy, and the physical strain of labour have been proposed as contributory factors in this association, but the exact mechanism remains unclear. Case 3 differed in that no predisposing factor could be identified."},{"key":"ref_2","first-page":"325","article-title":"MB (eds). Coronary artery dissections. In: Nonatherosclerotic ischemic heart disease","author":"Virmani, R.; Forman","year":"1989","unstructured":"Virmani R, Forman MB (eds). Coronary artery dissections. In: Nonatherosclerotic ischemic heart disease. New York: Raven Press, 1989:325-54."},{"key":"ref_3","first-page":"601","article-title":"Non-atherosclerotic coronary artery disease and sudden death in the young","volume":"68","author":"Corrado, D.; Thiene, G.; Cocco, P.; Frescura, C.","year":"1992","unstructured":"Corrado D, Thiene G, Cocco P, Frescura C. Non-atherosclerotic coronary artery disease and sudden death in the young. BrHeartJ 1992;68:601-7.","journal-title":"BrHeartJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/0002-9343(82)90853-1","article-title":"Spontaneous coronary artery dissection and eosinophilic inflammation: a cause and effect relationship?","volume":"72","author":"Robinowitz, M.; Virmani, R.; McAllister, H.A.","year":"1982","unstructured":"Robinowitz M, Virmani R, McAllister HA. Spontaneous coronary artery dissection and eosinophilic inflammation: a cause and effect relationship? Am Jf Med 1982;72:923-8.","journal-title":"Am Jf Med"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/0002-9378(90)91192-F","article-title":"Postpartum coronary artery dissection followed by heart transplantation","volume":"163","author":"Curiel, P.; Spinelli, G.; Petrella, A.; Gori, A.; De Maria, R.; Bonacina, E.","year":"1990","unstructured":"Curiel P, Spinelli G, Petrella A, Gori A, De Maria R, Bonacina E, et al. Postpartum coronary artery dissection followed by heart transplantation. Am Jf Obstet Gynecol 1990;163:538-9.","journal-title":"Am Jf Obstet Gynecol"},{"issue":"22","key":"ref_6","first-page":"434","article-title":"Dissecting aneurysm of the coronary artery in arachnodactyly","volume":"1960","author":"McKeown, F.","unstructured":"McKeown F. Dissecting aneurysm of the coronary artery in arachnodactyly. Br Heart J 1960;22:434-6.","journal-title":"Br Heart J"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/0002-9343(86)90032-X","article-title":"Dissecting hematoma (aneurysm) ofcoronary arteries","volume":"80","year":"1986","unstructured":"Dissecting hematoma (aneurysm) ofcoronary arteries. Am Jf Med 1986;80:317-19.","journal-title":"Am Jf Med"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/hrt.66.1.3","article-title":"Outcome of extensive coronary artery dissection during coronary angioplasty","volume":"66","author":"Cripps, T.R.; Morgan, J.M.; Rickards, A.F.","year":"1991","unstructured":"Cripps TR, Morgan JM, Rickards AF. Outcome of extensive coronary artery dissection during coronary angioplasty. Br Heart Jf 1991;66:3-6.","journal-title":"Br Heart Jf"},{"key":"ref_9","first-page":"830","article-title":"Isolated dissecting aneurysm of the coronary artery: report of a case apparently due to hypersensitivity angiitis","volume-title":"Ohio State Med Jf","volume":"65","author":"Barrett, D.L.","year":"1969","unstructured":"Barrett DL. Isolated dissecting aneurysm of the coronary artery: report of a case apparently due to hypersensitivity angiitis. Ohio State Med Jf 1969;65:830-2."},{"key":"ref_10","first-page":"470","article-title":"Spontaneous coronary artery dissection occurs with and without periadventitial inflammation","volume":"111","author":"Dowling, G.P.; Buja, L.M.","year":"1987","unstructured":"Dowling GP, Buja LM. Spontaneous coronary artery dissection occurs with and without periadventitial inflammation. Arch Pathol Lab Med 1987;111:470-2.","journal-title":"Arch Pathol Lab Med"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/0002-9149(75)90482-8","article-title":"The coronary arteries in Marfan's syndrome. A morphologic study","volume":"36","author":"Becker, A.E.; Mantgen, J.P.","year":"1975","unstructured":"Becker AE, Mantgen JP. The coronary arteries in Marfan's syndrome. A morphologic study. Am J Cardiol 1975;36: 315-21.","journal-title":"Am J Cardiol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.48.8.781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T02:06:07Z","timestamp":1765073167000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.48.8.781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1995,8,1]]},"published-print":{"date-parts":[[1995,8]]}},"alternative-id":["10.1136\/jcp.48.8.781"],"URL":"https:\/\/doi.org\/10.1136\/jcp.48.8.781","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,8]]}}}